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People with severe mental illness experienced more rapid increases in both weight and long-term blood sugar levels during the first three months after starting treatment with antipsychotic medication, according to a study from Karolinska Institutet and University College London published in The Lancet Psychiatry.

The researchers analyzed electronic health records from nearly 97,000 people in England aged between 18 and 59 with severe mental illness. The aim was to investigate how weight and HbA1c, a blood test that reflects average blood sugar levels over time, changed before and after treatment with second-generation antipsychotic medication was initiated.

During the first 90 days after treatment began, HbA1c increased by an average of 0.12 mmol/mol per week and weight by 0.21 kilograms (0.46 pounds) per week. Before treatment, the corresponding increases were 0.01 mmol/mol and 0.02 kilograms (0.04 pounds) per week, respectively.

After the first three months, the rate of change slowed. From day 91 and up to two years, HbA1c again increased by 0.01 mmol/mol per week, while weight increased by 0.03 kilograms (0.07 pounds) per week.

The study is based entirely on health record data and shows how the values changed around the start of treatment, rather than reporting results from a randomized treatment study. In addition, only around a quarter of the participants had at least one recorded HbA1c measurement and just over three-quarters had at least one weight measurement.

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